Total Prostate Specific Antigen (TPSA)

What it is

Total Prostate Specific Antigen, or TPSA, is a protein that’s produced by cells in the prostate gland. The prostate is a small gland found in men, located just below the bladder, which plays a role in producing seminal fluid. TPSA is normally present in the blood in very small amounts. It's a substance that is released into the bloodstream from prostate cells, both normal and abnormal ones.

Why it matters

Measuring TPSA levels in the blood can be a useful tool for doctors when looking at prostate health. It's not a diagnostic test on its own, but it can provide valuable information.

For men who are experiencing symptoms that might be related to the prostate, such as changes in urination, a raised TPSA level might prompt further investigation. It can also be used to monitor men who have been diagnosed with prostate cancer, to see how they are responding to treatment or if the cancer is returning after treatment.

It's important to understand that TPSA can be raised for many reasons, not all of which are serious or related to cancer.

What can cause it to be high or low

A number of factors can influence TPSA levels, leading to them being higher or lower than the typical range.

Factors that can cause TPSA to be higher:

• Benign Prostatic Hyperplasia (BPH): This is a common, non-cancerous enlargement of the prostate gland that often occurs as men get older. The increased size of the prostate can lead to more TPSA being released into the bloodstream.
• Prostatitis: This is inflammation of the prostate gland, which can be caused by infection or other factors. Inflammation can disrupt prostate cells and lead to a rise in TPSA.
• Prostate Cancer: Cancerous cells in the prostate can produce TPSA, and in some cases, they may produce it at a higher rate than normal cells.
• Recent Medical Procedures: Certain procedures involving the prostate, such as a digital rectal examination (DRE), a prostate biopsy, or even vigorous exercise shortly before a blood test, can temporarily increase TPSA levels.
• Urinary Tract Infection (UTI): An infection in the urinary tract can sometimes affect the prostate and lead to a temporary rise in TPSA.

Factors that can cause TPSA to be lower:

Generally, TPSA levels don't have a specific "low" threshold that causes concern in the same way a high level might. Very low levels are expected in individuals who have had their prostate removed (prostatectomy) or in younger men with healthy prostates. If TPSA levels are being monitored after treatment for prostate cancer, a consistently very low or undetectable level is usually a positive sign.

Lifestyle factors that may help

While lifestyle changes can't directly lower TPSA levels in a predictable way, maintaining a healthy lifestyle is beneficial for overall prostate health and can potentially influence factors that might affect TPSA. Discussing these with your GP is a good idea.

• Diet: A balanced diet rich in fruits, vegetables, and whole grains is generally recommended. Some research has explored the potential role of certain nutrients, like lycopene found in tomatoes, but more evidence is needed.
• Weight Management: Maintaining a healthy weight can contribute to overall well-being and may have positive effects on hormonal balance.
• Regular Exercise: Engaging in regular physical activity is beneficial for many aspects of health, including cardiovascular health and potentially prostate health.
• Hydration: Drinking adequate fluids is important for urinary tract health.
• Avoiding Constipation: Straining during bowel movements can sometimes put pressure on the prostate, so maintaining regular bowel habits is helpful.

Questions to discuss with your GP

If you have had a TPSA test, or are considering one, it’s always best to have a conversation with your GP. Here are some questions you might want to ask:

• What does my TPSA result mean in the context of my individual health and any symptoms I might be experiencing?
• What are the possible reasons for my TPSA level being higher or lower than the reference range?
• Are there any other tests or investigations that might be needed based on my TPSA result?
• How often should my TPSA levels be monitored, if at all?
• What are the potential benefits and limitations of using TPSA testing for monitoring my prostate health?
• Are there any lifestyle changes you would recommend for my overall prostate health?